1: Jpn J Thorac Cardiovasc Surg. 2005 Aug;53(8):443-7.
Pulmonary pleomorphic liposarcoma.
Ibe T, Otani Y, Shimizu K, Nakano T, Sano T, Morishita Y.
Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate
School of Medicine , Maebashi , Gunma , Japan .
Pulmonary liposarcoma is extremely rare with 6 cases previously reported in the English literature. The following is a report of a 36-year-old man with pulmonary liposarcoma. The patient had chest pain and a mass shadow in the right lower lung field was revealed on a chest X-ray film. A computed tomography and magnetic resonance imaging showed a heterogeneous tumor, compressing the right lower lobe of the lung. Because of the fatty tissue component in the tumor on the chest computed tomography, and the appearance as an extrapulmonary mass, preoperative diagnosis was posterior mediastinal liposarcoma. But thoracotomy revealed that the tumor originated from the lung. Right lower lobectomy and lymph node dissection was carried out with no additional therapy. The pathological diagnosis was pleomorphic liposarcoma originated from the lung. Two months after the operation, the patient died of respiratory failure due to local recurrence.
2: Ann Pathol. 2003 Sep;23(4):332-5.
Liposarcoma of the pleura: an exceptional tumor. A study of two cases
Hofman V, Venissac N, Mouroux J, Dugue P, Hofman P. Service d'Anatomie Pathologique, Hopital Pasteur , 06002 Nice Cedex 01.
Primitive intrathoracic liposarcomas are rare tumors mostly located in the mediastinum or in lung parenchyma. Primitive liposarcomas of the pleura are exceptional and show a dramatic clinical course. These tumors are treated by surgery sometimes associated with radiotherapy. We report 2 cases of primitive liposarcoma of the pleura occurring in 2 women of 19 and 62 years of age. Histological examination showed in both cases a low-grade myxoid liposarcoma. In one case, ultrastructural study confirmed the diagnosis.
3: Australas Radiol. 2003 Sep;47(3):313-7. Imaging features of primary pulmonary liposarcoma.
Said M, Migaw H, Hafsa C, Braham R, Golli M, Moussa A, Zakhama A, Elkamel A, Gannouni A.
Department of Diagnostic Radiology, Universitary Hospital of Monastir , Tunisia . mouradsaid@yahoo.fr
Primary liposarcoma of the lung is extremely rare. We report a 28-year-old pregnant woman who complained of dyspnoea during the third trimester. Chest radiography, thoracic ultrasound, CT and MRI showed a huge heterogeneous tumour involving all the left lung and the mediastinum. The tumour was composed of soft tissue, and fatty and cystic components with calcifications. Diagnosis was made on core biopsy under CT guidance. Surgical excision was performed but unfortunately the patient died during the operation.
4:Kyobu Geka. 2003 Jul;56(7):593-6.
Liposarcoma of the pleural cavity; report of a case
Arai H, Nakayama H, Ito H, Fujita A, Ikehara M, Tanaka G, Oshita F, Yamada K, Nomura I, Noda K, Mitsuda A, Kameda Y.
Division of Thoracic Surgery, Kanagawa Cancer Center , Yokohama , Japan .
A 43-year-old-woman who had severe anterior chest pain visited our hospital on April 3, 2000. A well-defined abnormal shadow was seen in the middle and lower field of the right lung on chest X-ray. Computed tomography showed a large fat density mass in the right pleural cavity with a septum enhanced by contrast medium. Percutaneous needle biopsy revealed lipoma or liposarcoma. Complete resection could be done with combined resection of right lung, lpericardium, parietal pleura and diaphragm. Final histologic diagnosis was well differentiated liposarcoma. There are few reports of liposarcoma arising in the thoracic cavity, we present our case and review the 23 cases reported from the Japanese literatures.
5: Lung Cancer. 2003 Jan;39(1):103-6.
Atypical lipomatous tumour (lipoma-like well-differentiated liposarcoma) arising in a pulmonary hamartoma and clinically presenting with pneumothorax.
Rossi G, Cavazza A, Valli R, Torricelli P, Richeldi L, Rivasi F, Brambilla E.
Department of Pathological Anatomy and Forensic Medicine, Section of Pathology, University of Modena and Reggio Emilia, Via del Pozzo, 71-41100, Modena , Italy . rossi.giulio@unimo.it
We document an uncommon variant of pulmonary hamartoma (PH), discovered in the left upper lobe of a 60-year-old man after an episode of pneumothorax, a unique clinical presentation for such an occurrence. The tumour showed a prominent leaf-like pattern and was mainly composed of mature fat with adipocytes of different size and scattered throughout lipoblasts and floret-like cells. A lobectomy was performed and more than 7 years after surgery the patient's course is still uneventful. This case represents an exceedingly rare example of an histologically malignant change in PH and bears a close clinicopathologic resemblance to atypical lipomatous tumours of soft tissues.
6: Rev Pneumol Clin. 2002 Jun;58(3 Pt 1):154-8.
Myxoid liposarcoma of the mediastinum: a case report
Smahi M, Serraj M, Achir A, al Aziz AS, el Masslout A, Benosman A.
Service de Chirurgie Thoracique, CHU Ibn Sina, Rabat , Maroc.
smahim71@hotmail.com We describe a mediastinal myxoid liposarcoma in a 47-year-old man who developed recurrent lung infection, treated by surgery associated with radiotherapy. The report of this case and a review of literature bring the authors to outline the epidemiological, clinical and therapeutic profile of this rare tumor.
7: Am J Surg Pathol. 2002 Jun;26(6):742-9.
Lipoleiomyosarcoma (well-differentiated liposarcoma with leiomyosarcomatous differentiation): a clinicopathologic study of nine cases including one with dedifferentiation.
Folpe AL, Weiss SW.
Department of Pathology, Emory University , Atlanta , Georgia 30322, USA .
afolpe@bellsouth.net
Leiomyosarcomatous (LMS) differentiation is a rare event in liposarcoma (LPS) and may consist of either well-differentiated liposarcoma (WDL) with an intrinsic smooth muscle component, so-called "lipoleiomyosarcoma," (L-LMS) or dedifferentiated liposarcoma having smooth muscle differentiation in the dedifferentiated zones. The latter are high-grade sarcomas, whereas the behavior of the former group is uncertain. Specifically, it is not clear whether the presence of LMS negatively affects the prognosis. We present our experience with nine cases, the largest to date. The patients (seven male, two female) ranged in age from 42 to 65 years (mean 54 years). The tumors were usually large (2 to >40 cm [mean 17 cm]) tumors in the retroperitoneum (two cases), paratesticular-inguinal region (three cases), mediastinum (one case), lung (one case), abdomen (one case), and popliteal fossa (one case). The nine cases qualified as L-LMS and showed typical WDL with a multifocal, gradual transition into smooth muscle areas. The latter areas accounted for a variable portion of the lesions (range 5-90%) and were of low cellularity, mild to moderate nuclear atypia, and low mitotic activity. These areas seemed to arise from or blend with the smooth muscle in the walls of large vessels within the tumor. One case showed areas of dedifferentiation consisting of actin and desmin-negative, high-grade sarcoma. Follow-up in seven cases (range 26-312 months; mean 119 months) showed multiple local recurrences in seven patients and no metastases. Three patients are currently without evidence of disease (follow-up duration 26-312 months; mean 144 months) and four patients are alive with progressive disease (follow-up duration 60-132 months; mean 99 months). Our study suggests that L-LMS is a dual lineage sarcoma as evidenced by the fact that the smooth muscle component is often multifocal, not necessarily found in close association with the atypical changes in fat, and seemingly originates from atypical ("in situ") changes in the vessel wall. The LMS component, which is typically low grade, does not adversely affect the overall behavior of the tumor, which is similar to that of conventional WDL. LMS in L-LMS should not be misconstrued as evidence of low-grade dedifferentiation, a phenomenon that identifies a more unstable and potentially metastasizing lesion.
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